Opioid use disorder is a chronic disease associated with a high burden of excess mortality.[171]Larney S, Tran LT, Leung J, et al. All-cause and cause-specific mortality among people using extramedical opioids: a systematic review and meta-analysis. JAMA Psychiatry. 2020 May 1;77(5):493-502.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990804
http://www.ncbi.nlm.nih.gov/pubmed/31876906?tool=bestpractice.com
Relapse rates are >90% in untreated patients.[172]McLellan AT, Luborsky L, Woody GE, et al. Predicting response to alcohol and drug abuse treatments: role of psychiatric severity. Arch Gen Psychiatry. 1983 Jun;40(6):620-5.
http://www.ncbi.nlm.nih.gov/pubmed/6847331?tool=bestpractice.com
However, with effective treatment, relapse rates are similar to those in other well-characterized chronic medical illnesses, such as diabetes, hypertension, and asthma.[173]McLellan AT, Lewis DC, O'Brien CP, et al. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. JAMA. 2000 Oct 4;284(13):1689-95.
http://www.ncbi.nlm.nih.gov/pubmed/11015800?tool=bestpractice.com
The treatment of opioid use disorder involves modifying deeply ingrained behaviors; relapse does not equal treatment failure. With each relapse, the patient and healthcare providers need to evaluate whether to reinstate treatment, adjust current treatment, or find alternative treatment based on the biopsychosocial model.
While there is no “cure” for opioid use disorder, evidence-based treatments can significantly reduce morbidity and mortality, and effectively support patients in reintegrating into society.[70]Santo T Jr, Clark B, Hickman M, et al. Association of opioid agonist treatment with all-cause mortality and specific causes of death among people with opioid dependence: a systematic review and meta-analysis. JAMA Psychiatry. 2021 Sep 1;78(9):979-93.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8173472
http://www.ncbi.nlm.nih.gov/pubmed/34076676?tool=bestpractice.com